South Africa continues to grapple with a persistent tobacco use problem, as evidenced by the recently released 2021 Global Adult Tobacco Survey report. The Department of Health unveiled the findings, which paint a concerning picture of the nation's smoking habits. The survey, which sampled 7,245 households, revealed that the prevalence of tobacco use in South Africa stands at a staggering 29.4%, significantly higher than many other countries.
The data also highlighted a notable gender disparity in tobacco consumption. A higher percentage of men (41.7%) currently use tobacco compared to women (17.9%). Dr. Catherine Egbe, the lead investigator from the South African Medical Research Council, further elaborated on the findings, stating that 21.2% of adults in South Africa smoke daily, while 4.6% smoke occasionally. The Northern Cape and Western Cape provinces exhibited the highest prevalence of tobacco use, while Limpopo had the lowest.
One of the most alarming aspects of the report was the declining age of smoking initiation. The average age at which individuals started using tobacco was found to be 17.6 years among adults aged between 20 and 34. Even more concerning, 20.9% of urban residents and 13.5% of rural residents began smoking before the age of 15. This trend suggests that young people are increasingly vulnerable to the lure of tobacco products, potentially setting the stage for lifelong addiction and health complications.
The survey also delved into the use of alternative tobacco products, such as e-cigarettes and hookah pipes. Approximately 2.2% of respondents reported currently using e-cigarettes, with men (3.8%) more likely to use them than women (0.7%). Among e-cigarette users, enjoyment (70.3%), flavor (67.5%), perceived lower harm compared to traditional tobacco (45.1%), and the influence of friends or family members (43.5%) were cited as primary reasons for their use. Additionally, 3.1% of adults reported smoking hookah pipes or hubbly bubbly, with the average age of initiation being 21.1 years for all users and 17.3 years for those aged 15-24.
The report also shed light on the challenges faced by those attempting to quit smoking. Among current tobacco users, 80.9% tried to quit without assistance, while only 4.1% used pharmacotherapy. Disturbingly, just 42.9% of smokers received advice from their healthcare providers to stop smoking. This lack of support and guidance may contribute to the difficulty many individuals face when trying to break free from tobacco addiction.
Exposure to second-hand smoke (SHS) emerged as another significant concern. The data revealed that 74.4% of adults who visited public places were exposed to SHS at bars, taverns, shebeens, or nightclubs. Educational institutions were not immune to this problem, with 19.9% of adults exposed to SHS at schools and 16.0% at tertiary institutions. Cafes also contributed to the issue, with 11.3% of adults encountering SHS in these establishments.
The South African government recognizes the urgent need to address the tobacco epidemic. Jeanette Hunter, the Deputy Director of General Primary Healthcare at the Department of Health, expressed particular concern about the increasing use of hookah, e-cigarettes, and vapes among young people. She emphasized that despite aggressive marketing campaigns portraying these products as healthier alternatives to traditional tobacco, scientific evidence has highlighted the associated health risks.
In response to these challenges, the government has taken legislative action by amending the existing Tobacco Product Control Act to incorporate the control of electronic delivery systems. The amendment bill is currently undergoing parliamentary processes. Additionally, the Department of Health has identified the need to establish tobacco cessation programs in primary healthcare facilities and is exploring the feasibility of such initiatives.
